1. Department of Medicine (Dermatology), University of Washington, Seattle, Washington, U.S.A.
2. ^*The Jackson Laboratory, Bar Harbor, Maine, U.S.A.
3. ^†Departments of Pathology, Duke University Medical Center & Veterans Affairs Medical Centers, Durham, North Carolina, U.S.A.
4. ^‡Departments of Microbiology and Pathology, Duke University Medical Center, Durham, North Carolina, U.S.A.

Correspondence: Dr Philip Fleckman, University of Washington, Division of Dematology, Box 356524, Seattle, WA 98195-6524, U.S.A. Email: fleck@u.washington.edu

Received 5 January 1998; Revised 15 April 1999; Accepted 21 April 1999.

Abstract

This is a case report of an immunocompromised individual who presented with progressive alopecia, friable follicular spinous processes, and erythematous, indurated papules. Examination of skin biopsies using light microscopy and immunohistochemistry revealed pathologic changes of the follicular inner root sheath epithelium with dystrophic trichohyaline granules. Electron microscopy of thin sections of tissue revealed intracellular viral particles with a size and appearance consistent with those in the Papovaviridae family. Electron microscopy of negatively stained extract from a homogenized lesion also demonstrated icosahedral viruses with papovavirus morphology. We believe this is a previously unreported folliculocentric viral infection in an immuno-suppressed human host and have termed this entity "trichodysplasia spinulosa".